The Urinary System Physiology
The urinary system is the main excretory system in the human body. It comprises the following
structures: Two kidneys, two ureters, the urinary bladder and the urethra.
This system plays a vital part in maintaining the body's homeostasis of water and electrolytes. The
kidneys produce urine that contains metabolic waste products, including the nitrogenous
compounds urea and uric acid, excess ions and some drugs.
Functions of the Kidney
The kidneys filter 200 litres of blood daily, allowing toxins, metabolic wastes, and excess ions to
leave the body in the urine
It regulated the volume and chemical makeup of the blood
It also maintains the proper balance between water and salts, and acids and bases
Other Renal Functions
-Gluconeogenesis during prolonged fasting
-Production of rennin to help regulate blood pressure and erythropoietin to stimulate RBC
production
-Activation of vitamin D
Other Urinary System Organs
Urinary bladder – provides a temporary storage reservoir for urine
Paired ureters – transport urine from the kidneys to the bladder
Urethra – transports urine from the bladder out of the body
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Urinary System Organs
Kidney Location and External Anatomy
The bean-shaped kidneys lie in a retroperitoneal position in the superior lumbar region and extend
from the twelfth thoracic to the third lumbar vertebrae.
The right kidney is lower than the left because it is crowded by the liver
The lateral surface is convex and the medial surface is concave, with a vertical cleft called the renal
hilus leading to the renal sinus
Ureters, renal blood vessels, lymphatics, and nerves enter and exit at the hilus
Layers of Tissue Supporting the Kidney
Renal capsule – a fibrous capsule that prevents kidney infection
Adipose capsule – fatty mass that cushions the kidney and helps attach it to the body wall
Renal fascia – outer layer of dense fibrous connective tissue that anchors the kidney
Internal Anatomy
A frontal section shows three distinct regions
Cortex – the light-colored, granular superficial region
Medulla – exhibits cone-shaped medullary (renal) pyramids
Pyramids are made up of parallel bundles of urine-collecting tubules
Renal columns are inward extensions of cortical tissue that separate the pyramids
The medullary pyramid and its surrounding capsule constitute a lobe
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Renal pelvis – flat, funnel-shaped tube lateral to the hilus within the renal sinus
Major calyces – large branches of the renal pelvis
Collect urine draining from papillae
Empty urine into the pelvis
Urine flows through the pelvis and ureters to the bladder
Blood and Nerve Supply
Approximately one-fourth (1200 ml) of systemic cardiac output flows through the kidneys each
minute.
Arterial flow into and venous flow out of the kidneys follow similar paths
The nerve supply is via the renal plexus
The Nephron
Nephrons are the structural and functional units that form urine, consisting of:
Glomerulus – a tuft of capillaries associated with a renal tubule
Glomerular (Bowman’s) capsule – blind, cup-shaped end of a renal tubule that completely
surrounds the glomerulus
The Nephron
Renal corpuscle – the glomerulus and its Bowman’s capsule
Glomerular endothelium – fenestrated epithelium that allows solute-rich, virtually protein-free
filtrate to pass from the blood into the glomerular capsule
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Anatomy of the Glomerular Capsule
The external parietal layer is a structural layer
The visceral layer consists of modified, branching epithelial podocytes
Extensions of the octopus-like podocytes terminate in foot processes
Filtration slits – openings between the foot processes that allow filtrate to pass into the capsular
space
Renal Tubule
Proximal convoluted tubule (PCT) – composed of cuboidal cells with numerous microvilli and
mitochondria
Reabsorbs water and solutes from the filtrate and secretes substances into it
Loop of Henle – a hairpin-shaped loop of the renal tubule
The proximal part is similar to the proximal convoluted tubule
The proximal part is followed by the thin segment (simple squamous cells) and the thick segment
(cuboidal to columnar cells)
Distal convoluted tubule (DCT) – cuboidal cells without microvilli that function more in secretion
than reabsorption
Connecting Tubules
The distal portion of the distal convoluted tubule nearer to the collecting ducts
Two important cell types are found here
Intercalated cells - Cuboidal cells with microvilli which have a function in maintaining the acid-
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base balance of the body
Principal cells - Cuboidal cells without microvilli that help maintain the body’s water and salt
balance
Nephrons
Cortical nephrons – 85% of nephrons; are located in the cortex
Juxtamedullary nephrons:
Are located at the cortex-medulla junction
Have loops of Henle that deeply invade the medulla
Have extensive thin segments
Are involved in the production of concentrated urine
Capillary Beds of the Nephron
Every nephron has two capillary beds
Glomerulus
Peritubular capillaries
Each glomerulus is:
Fed by an afferent arteriole
Drained by an efferent arteriole
Capillary Beds of the Nephron
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Blood pressure in the glomerulus is high because:
Arterioles are high-resistance vessels
Afferent arterioles have larger diameters than efferent arterioles
Fluids and solutes are forced out of the blood throughout the entire length of the glomerulus
Capillary Beds
Peritubular beds are low-pressure, porous capillaries adapted for absorption that:
Arise from efferent arterioles
Cling to adjacent renal tubules
Empty into the renal venous system
Vasa recta – long, straight efferent arterioles of juxtamedullary nephrons
Vascular Resistance in Microcirculation
Afferent and efferent arterioles offer high resistance to blood flow
Blood pressure declines from 95mm Hg in renal arteries to 8 mm Hg in renal veins
Vascular Resistance in Microcirculation
Resistance in afferent arterioles:
Protects glomeruli from fluctuations in systemic blood pressure
Resistance in efferent arterioles:
Reinforces high glomerular pressure
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Reduces hydrostatic pressure in peritubular capillaries
Juxtaglomerular Apparatus (JGA)
Where the distal tubule lies against the afferent (sometimes efferent) arteriole
Arteriole walls have juxtaglomerular (JG) cells
Enlarged, smooth muscle cells
Have secretory granules containing renin
Act as mechanoreceptors
Juxtaglomerular Apparatus (JGA)
Macula densa
Tall, closely packed distal tubule cells
Lie adjacent to JG cells
Function as chemoreceptors or osmoreceptors
Mesangial cells:
Have phagocytic and contractile properties Influence capillary filtration
Filtration Membrane
Filter that lies between the blood and the interior of the glomerular capsule
It is composed of three layers
Fenestrated endothelium of the glomerular capillaries
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Visceral membrane of the glomerular capsule (podocytes)
The basement membrane is composed of fused basal laminae of the other layers
Mechanisms of Urine Formation
The kidneys filter the body’s entire plasma volume 60 times each day
The filtrate:
Contains all plasma components except protein
Loses water, nutrients, and essential ions to become urine
The urine contains metabolic wastes and unneeded substances
Mechanisms of Urine Formation
Urine formation and adjustment of blood composition involves three major processes
1. Glomerular filtration
2. Tubular reabsorption
3. Secretion
Glomerular Filtration
Principles of fluid dynamics that account for tissue fluid in all capillary beds apply to the
glomerulus as well
The glomerulus is more efficient than other capillary beds because:
Its filtration membrane is significantly more permeable
Glomerular blood pressure is higher
It has a higher net filtration pressure
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Plasma proteins are not filtered and are used to maintain the oncotic pressure of the blood
Net Filtration Pressure (NFP)
The pressure responsible for filtrate formation NFP equals the glomerular hydrostatic pressure
(hpg) minus the oncotic pressure of glomerular blood (opg) combined with the capsular hydrostatic
pressure (hpc) NFP = HP g – (opg + hpc)
Glomerular Filtration Rate (GFR)
The total amount of filtrate formed per minute by the kidneys
Factors governing filtration rate at the capillary bed are:
Total surface area available for filtration
Filtration membrane permeability
Net filtration pressure
Glomerular Filtration Rate (GFR)
GFR is directly proportional to the NFP
Changes in GFR normally result from changes in glomerular blood pressure
Regulation of Glomerular Filtration
If the GFR is too high:
Needed substances cannot be reabsorbed quickly enough and are lost in the urine
If the GFR is too low:
Everything is reabsorbed, including wastes that are normally disposed of
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Three mechanisms control the GFR
Renal autoregulation (intrinsic system)
Neural controls
Hormonal mechanism (the renin-angiotensin system)
Intrinsic Controls
Under normal conditions, renal autoregulation maintains a nearly constant glomerular filtration rate
Autoregulation entails two types of control
Myogenic – responds to changes in pressure in the renal blood vessels
Flow-dependent tubuloglomerular feedback – senses changes in the juxtaglomerular apparatus
Extrinsic Controls
When the sympathetic nervous system is at rest:
Renal blood vessels are maximally dilated
Autoregulation mechanisms prevail
Extrinsic Controls
Under stress:
Norepinephrine is released by the sympathetic nervous system
Epinephrine is released by the adrenal medulla
Afferent arterioles constrict and filtration is inhibited
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The sympathetic nervous system also stimulates the renin-angiotensin mechanism
The renin-angiotensin-aldosterone system (RAAS) is a crucial hormonal mechanism that
regulates blood pressure, fluid balance, and electrolyte homeostasis. It is activated primarily in
response to hypovolemia, hypotension, or sodium depletion.
Activation of RAAS
The system is initiated when juxtaglomerular (JG) cells of the afferent arterioles in the kidney
secrete renin, an enzyme that catalyzes the cascade.
Renin Release: Triggers
Renin is secreted in response to three main stimuli:
1. Reduced renal perfusion pressure (hypotension) sensed as decreased stretch of JG cells
(intrarenal baroreceptor mechanism)
2. Decreased sodium chloride concentration at the macula densa of the distal tubule, which
stimulates JG cells via tubuloglomerular feedback
3. Sympathetic nervous system activation, specifically ?1-adrenergic receptor stimulation
on JG cells by renal sympathetic nerves
Biochemical Cascade
1. Renin converts angiotensinogen (produced by the liver) into angiotensin I
2. Angiotensin I is then converted into angiotensin II by angiotensin-converting enzyme
(ACE), primarily in the pulmonary endothelium
Actions of Angiotensin II
Angiotensin II is a potent vasoconstrictor and has several critical physiological effects:
Increases systemic vascular resistance (SVR) ? elevates mean arterial pressure (MAP)
Stimulates the adrenal cortex (zona glomerulosa) to secrete aldosterone, which:
Increases sodium and water reabsorption in the distal nephron
Promotes potassium and hydrogen ion excretion
Enhances proximal tubular sodium reabsorption
Stimulates thirst via the hypothalamus and promotes antidiuretic hormone (ADH) release
from the posterior pituitary
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Constriction of efferent arterioles of the glomerulus ? increases glomerular capillary
hydrostatic pressure and helps maintain glomerular filtration rate (GFR) despite low
renal perfusion
Net Effects of RAAS Activation
Increased blood volume and blood pressure
Restoration of renal perfusion
Homeostasis of sodium and potassium levels
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